The mean genetic distances in clade B increased over time and with the distance between sampling locations.
Bayesian birth-death and coalescent skyline plots of the clade B showed that the effective number of infections and the effective reproduction number (Re) increased between 20.
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To reconstruct the evolutionary dynamics and epidemiological history of the virus in Italy, 53 envelope gene and 26 complete genome sequences obtained from human and animal samples were characterised by means of next-generation sequencing.
Phylogenetic analysis revealed two Italian strains originating between 20: clade A, which apparently became extinct in 2013–2014, and clade B, which was responsible for the 2018 epidemic.
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After an adaptation period of a few years, the newly introduced viruses spread quickly across the Americas and Europe.
Humans, horses, and birds have been confirmed to be susceptible hosts for WNV, with clinical symptoms ranging from mild to life-threatening neuro-invasive West Nile disease.